Provider Demographics
NPI:1922257195
Name:TARZANA TREATMENT CENTER
Entity Type:Organization
Organization Name:TARZANA TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEER ADVOCATE
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-428-4111
Mailing Address - Street 1:5190 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-6510
Mailing Address - Country:US
Mailing Address - Phone:562-428-4111
Mailing Address - Fax:562-984-5610
Practice Address - Street 1:5190 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-6510
Practice Address - Country:US
Practice Address - Phone:562-428-4111
Practice Address - Fax:562-984-5610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health